| David Gannon, Md | |
|
2550 24th St Rock Island IL 61201-5304 | |
| (309) 793-4223 | |
| (309) 793-6276 |
| Full Name | David Gannon, Md |
|---|---|
| Speciality | Family Medicine |
| Location | 2550 24th St, Rock Island, Illinois |
| Authorized Official Name and Position | David Gannon (DOCTOR) |
| Authorized Official Contact | 3097394223 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| David Gannon, Md 602 35th Ave Moline IL 61265-6145 Ph: (309) 736-4173 | David Gannon, Md 2550 24th St Rock Island IL 61201-5304 Ph: (309) 793-4223 |
| NPI Number | 1275687113 |
|---|---|
| Provider Enumeration Date | 01/22/2007 |
| Last Update Date | 10/11/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275687113 | NPI | - | NPPES |
| 0360532801 | Medicaid | IL | |
| 8132003 | Other | IL | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
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